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Each year researchers with an interest in studying the various aspects of essential tremor are encouraged to submit scientific proposals for grant funding from the IETF. To date, your research donations have provided nearly $1 million to fund numerous promising studies. This year, the IETF will fund three essential tremor research grants totaling $80,000. Grant funding was provided to the IETF from donors, people directly affected by this life-altering condition, like you.

The IETF will award $35,000 to the study entitled “Testing the GABA Nucleo-Olivary Hypothesis of Essential Tremor.” The goal of this research is to systematically test whether impaired function or degeneration of GABAergic N-O neurons induces action tremor, supporting the hypothesis that such mechanisms underlie at least some cases of ET. Read more…

The second study to be awarded $20,000 from the IETF is “Essential Tremor Research Program: Cannabidiol Anti-Tremor Action and Mechanisms.” This research will explore the effects of a particular cannabinoid known as “CBD” (cannabidiol) on ET. Unlike the well-known cannabinoid “THC” (tetrahydrocannabinol), which has mood-altering effects, CBD does not impact mood. CBD has already shown some promising initial results in the treatment of epilepsy, pain, anxiety, and other disorders. Read more…

The final study, “Abnormal Climbing Fiber-Purkinje Cell Synapses in Essential Tremor” will be awarded $25,000. This study will be conducted by Dr. Sheng-Han Kuo, Assistant Professor of Neurology at Columbia University in New York. Dr. Kuo’s team will build upon previous research after discovering an unknown abnormality in essential tremor patients at the location in the brain where the neuron’s electrical and chemical signals are transmitted and received. Read more…

Your research donation could make the difference between critical research being funded, or being turned away. Every donation, no matter the size, counts. Help us keep research moving forward! Make a research donation today and learn more about IETF-funded research.

The IETF is excited to fund three new research studies totaling $85,000 this year. These studies are stepping stones to moving our knowledge forward and can provide progress to change the world for everyone with ET.

The Role of Excitotoxicity in ET Cerebellum – IETF Funded $25,000
The goal of this research is to investigate the role of excitotoxicity in the postmortem ET cerebellum. Excitotoxicity is the pathological process by which nerve cells are damaged and killed by excessive stimulation by neurotransmitters. It has been a suggested approach for ET, however there has yet to be any direct evidence that excitotoxicity plays a role in ET patients. Read more.

Cerebello-Thalamo-Cortical Coupling in ET: Effects of High-Frequency Cerebellar Stimulation on Brain Activity & Tremor – IETF Funded $25,000
Tremor is associated with abnormal activity within different brain regions, particularly the thalamus and cerebellum. Transcranial stimulation (tACS) of the cerebellum may represent a non-invasive therapeutic option for ET patients. TACS is a new technique allowing manipulation of rhythmic patterns in the brain’s cortex with externally applied electrical frequencies. Read more.

A Feasibility Study for an ET Brain Bank at the Arizona Study of Aging & Neurodegenerative Disorders – IETF Funded $35,000
Now in its third IETF-funded year, researchers will continue to examine the brain tissue of those with ET and other neurological disorders after death, searching for a greater understanding of how ET changes the features of the brain, and hopefully leading to more effective diagnostic tools. Read more.

Grant funding was provided to the IETF from its own annual donors, people directly affected by this life-altering condition. If you’d like to become an annual donor, please click here. As our way of saying thank you, you will also receive the new e-book “Essential Tremor: What the Experts Say.”

A recent IETF-funded study shows resistance training to be a possible therapy for individuals with ET. A team of researchers from Griffith University and Bond University in Australia identified that a generalized resistance training program for the upper limb is capable of improving manual dexterity in individuals with ET, and to a lesser degree, reduce abduction force tremor.

“Given that resistance training (RT) can reduce tremor amplitude and improve upper limb fine motor control in older adults, it is surprising that few studies have explored RT as a therapy for older adults with ET,” said Dr. Justin Keogh, Faculty of Health Sciences and Medicine of Bond University.

The lack of existing research inspired Keogh and his research team to compare healthy, older adults living with ET to those without ET through function tests. The function tests were used to assess activities common to everyday life. After a six-week resistance training program involving dumbbell bicep curls, wrist flexion and wrist extension exercises, functions test results significantly improved.

Results show that a simple dumbbell-based resistance training program had many significant benefits for older adults, with and without essential tremor. This indicated that both groups of older adults can significantly improve many real-world measures of manual dexterity. The greatest benefits following resistance training were gained for the limb most affected due to the disorder. This study is great news for individuals with ET to further explore the use resistance training as a viable therapy for improving upper
limb-function and ultimately, improving their quality of life.

The NIH announced the formation of a new brain and tissue repository network, NeuroBioBank, in order to create better access to post-mortem samples for those researchers studying brain disorders. Brain banks accept brain and tissue donations from people affect by brain diseases and from non-affected individuals, searching for changes that may offer insight into the cause of disorders such as essential tremor, depression, multiple sclerosis and autism.

Until now, brain banks were funded in a piece-meal sort of fashion; individual researchers requested funds for a specific disease or their specific bank. With this project, the NIH is looking to consolidate its funding efforts into a larger, more effective, standardized repository.

In September of 2013, contracts totaling $4.7 million were awarded to five brain bank repositories: Mt. Sinai School of Medicine, New York City; Harvard University in Cambridge, MA; University of Miami; Sepulveda Research Corp., Los Angeles; and the University of Pittsburgh. These banks have already begun developing a web-based sharing system that will allow the whole of the neuroscience community access to brain tissue samples and data, with a simple click of a mouse.

“Instead of having to seek out brain tissue needed for study from scattered repositories, researchers will have one-stop access to the specimens they need,” explained Thomas Insel, MD, director of NIH’s National Institute of Mental Health.

Other brain banks, such as those funded by the IETF for the study of essential tremor, may become eligible to become contract sites of the NeuroBioBank in the future. In the meantime, the five current NeuroBioBank sites will soon be uploading their specimen inventories and clinical data (early 2014) so that researchers from around the globe can identify available specimens and further our understanding of the inner workings of brain and brain disorders.

Deep Brain Stimulation (DBS) has been around for many years and is one of the most common surgical options for the treatment of essential tremor. Recently, a new system has been developed that takes DBS to the next level. The new device actually senses and records the brain signals that cause the symptoms of essential tremor and other movement disorders, allowing researchers the opportunity to see exactly what signals are related to abnormal movements.

Although approved for use in the European Union in January, Medtronic’s Activa PC+S system has not been approved by the Food and Drug Administration (FDA) for use in the United States. However, the new device is currently cleared for study in the U.S. and two patients with advanced Parkinson’s disease have already undergone the surgical implantation of the new device.

The hope is that in the near future, this technology will develop to a level where the device itself will monitor the patient’s brain activity and automatically adjust therapy based on the individual’s needs– just as a pacemaker does for heart patients today. This would be a big advancement in DBS if this technology can be developed. Instead of DBS sending a constant, unchanging signal to cancel out tremor symptoms, the device itself would automatically make adjustments and changes to offer patients optimum benefit.

Read more about this study here or learn more about surgical options for essential tremor in this webinar.

As Director of Stereotactic and Functional Neurosurgery at the University of Virginia,Dr. Elias has led a number of research investigations. In 2011, his team became the first in the world to successfully treat a person with disabling [essential] tremor using focused ultrasound that was guided by magnetic resonance imaging (MRI). This procedure and subsequent clinical trials have resulted in an outpouring around the globe of investigations using ultrasound interventions to treat disorders of the brain. ¹

In his presentation, Dr. Elias shared his study results along with a message of the importance of research to further scientific advances.

Watch the taped presentation. Dr. Elias is the second to the last speaker (click on the timeline at approximately 08:30.00 to get right to his section).

Deep brain stimulation (DBS) is a surgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain.

The Defense Advanced Research Projects Agency (DARPA) is the agency of the United States Department of Defense responsible for the development of new, advanced technologies in order to maintain the technological superiority of the U.S. military. DARPA recently announced that it will commit $70 million over the next five years to the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative. More specifically, to further investigate Deep Brain Stimulation (DBS).

Deep brain stimulation (DBS) surgery is an FDA-approved treatment that has been proven to significantly reduce the tremor associated with ET. In DBS surgery, a wire (electrode or lead) is placed in the ventral intermediate nucleus (VIM) nucleus of the thalamus, located deep in the brain. The wire connects under the skin to a pacemaker-like device in the chest, which provides mild electrical currents to control symptoms. In ET, DBS of the VIM nucleus of the thalamus is the most commonly used surgical procedure to control tremor.

Advances in technology have now opened up this option for other complex conditions such as depression, which is precisely why DARPA is so interested in the technology. According to the U.S. Department of Veterans Affairs, 10% to 18% of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) troops are likely to have PTSD after they return from service. That is a significant number of men and women who may require treatment.

So what does this initiative mean for those affected by essential tremor? DARPA would like to see DBS go further than just treat symptoms. “There is no technology that can acquire signals that can tell them precisely what is going on with the brain,” says Justin Sanchez, DARPA program manager, to The New York Times. He explained that DARPA is “trying to change the game on how we approach these problems.”

DARPA hopes to develop DBS to the point that the device will be able to monitor brain signals in real time, treat illness accordingly and measure the success of that treatment. This would be a real games changer for ET patients suffering from severe tremor symptoms. Imagine never having to turn the DBS device on or off, or have it calibrated. It would be programed to know exactly how to manage individual tremor symptoms, then evaluate the results and make adjustments accordingly.

Only time will tell if DARPA is successful with this ambitious project. But even if all their goals are not realized, they are bound to discover an abundance of new information about how the brain works.

Scientists recently released a study that could be a useful aid in diagnosing essential tremor.

Researchers at Columbia University found 20% of essential tremor patients in the study exhibited a head snap, which is a jerking motion of the head while engaging in the finger-nose-finger maneuver. In this maneuver, people touch their nose with their finger and then try to touch the examiner’s finger in an alternating fashion to test for tremor.

The study also documented the prevalence of head snap to Parkinson’s disease patients, and they found that none of these patients exhibited head snap.

Because so many ET patients are misdiagnosed (approximately 30-50%), many as having Parkinson’s, researchers hope attention to head snap will lead to more accurate diagnosis of essential tremor.

The first patient has been treated as part of a Phase III trial evaluating the success and safety of treatment using the ExAblate Neuro on essential tremor patients. The study builds on promising pilot studies demonstrating the preliminary safety and effectiveness of MR guided focused ultrasound technology. Read about Phase I of the trial here.

The results of this trial are expected to support a submission of the ExAblate Neuro to the FDA for Pre-Market Approval.

InSightec, makers of the ExAblate Neuro, will be partnering with BIRD (US-Israel Binational Industry R&D) and the Focused Ultrasound Foundation for this trial.

Find information on registering for this and other essential tremor studies at clinicaltrials.gov.

Dr. Jeff Elias (center) and the patients who participated in the essential tremor study at UVA

The New England Journal of Medicine published the results of the pilot trial for the use of focused ultrasound to treat patients with essential tremor. These Phase I results indicate that focused ultrasound can safely and effectively treat targeted areas deep in the brain. In focused ultrasound, more than 1,000 ultrasound waves are focused to a single site in the thalamus for the treatment.

The study included 15 patients with essential tremor that could not be managed by medication. Jeffrey Elias, MD, neurosurgeon at the University of Virginia and IETF Medical Advisory Board member, is the lead investigator of the study.

Phase I findings:

Dominant hand tremor improved by 75 percent.

Substantial improvements in daily disabilities (85 percent) and quality of life as assessed by clinicians and patients.

Outcomes and complications were comparable to surgical procedures for tremor, including radio frequency thalamotomy and deep brain stimulation.

Phase III of this study will begin soon. For information on how to register, visit clinicaltrials.gov.

The IETF will continue to watch as results of focused ultrasound studies are posted. Large, randomized controlled trials will be required to assess the procedure’s efficacy and safety.

Watch a video featuring Billy Williams, the first patient treated with focused ultrasound for essential tremor.